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Early-onset hereditary motor and sensory neuropathies are rare diseases representing a broad clinical and genetic spectrum. Without a notable familial history, the clinical diagnosis is complicated because acquired causes of peripheral neuropathy, such as inflammatory neuropathies, neuropathies with toxic causes, and nutritional deficiencies, must be considered. We examined the clinical, electrophysiological, and pathologic manifestations of a boy with an initial diagnosis of chronic inflammatory demyelinating polyneuropathy. The progression of the disease despite treatment led to a suspicion of hereditary motor and sensory neuropathy. Genetic testing revealed the presence of the MPZ p.D90E mutation in heterozygosis. To clarify the pathogenicity of this mutation and achieve a conclusive diagnosis, we investigated the MPZ p.D90E mutation through in silico and cellular approaches. This study broadens the clinical phenotype of hereditary motor and sensory neuropathy due to MPZ mutation and emphasises the difficulty of achieving an accurate genetic diagnosis in a sporadic patient to provide an appropriate pharmacologic treatment.

Original publication

DOI

10.1177/0883073815571049

Type

Journal article

Journal

J Child Neurol

Publication Date

10/2015

Volume

30

Pages

1544 - 1548

Keywords

MPZ gene, aggregation assay, de novo mutation, hereditary motor and sensory neuropathy, inflammatory neuropathy, Child, Preschool, Disease Progression, HeLa Cells, Hereditary Sensory and Motor Neuropathy, Humans, Male, Mutation, Myelin P0 Protein, Phenotype, Sural Nerve